Dear friends of the NLN,

We kick off the New Year with our first e-Channel of 2013. We have an ambitious schedule for the year ahead which includes expanding our reach to more patients affected by lymphedema. There are many underlying causes to lymphedema, and every patient has a different set of needs and concerns. This e-Channel focuses on bandaging and its challenges, including tips on utilizing bandage alternatives beyond the bedroom.

e-Channel is more focused, providing more practical guidelines for care as well as presenting day-to-day issues. These experiences, good, not so good, and sometimes frustrating, define what it means to live with lymphedema. Your stories Give Voice to our community. The stories are passed around in support groups, exchanges with your doctor and therapist, and the stranger on the street that asks what you have on your arm or leg. Many patients have little to no support, and we want them to know that there is a community for them - one that is more than willing to provide help and support. Please do not be shy and share your experiences, and show that, above all, life is just brilliant and even more fulfilling if you have to wear a garment every day.

Thank you to our new e-Channel editorial committee for volunteering their time and expertise.

The NLN staff is looking forward to a productive year for the lymphedema community nationwide, and we wish everyone a healthy and happy New Year!

Kind Regards,

Saskia R.J. Thiadens, RN & NLN staff 

What is a "Night Garment"? When I first began treating lymphedema, I never used the terminology "Night Garment". I used to teach all patients how to remove the elastic compression garment that was worn during the day and then self bandage the limb at night before going to bed. Over the years, however, there has been a burst of alternative options to use in place of self-bandaging during Phase II of Complete Decongestive Therapy - Self-Care Management. I began referring to these garments as "Night Garments" because they are most commonly used at night during sleep.

Night garments can be described as alternative nonelastic compression garments that are made to replace bandaging in order to improve quality of life by making the process of compressing the limb at night easier and faster to apply. Over the years, I have been able to incorporate the use of so many of these night garments successfully in self-care management. I almost always recommend the option of using a night garment somewhere in the patient's self care regimen because I feel it does allow the patient to be more compliant.

What I have learned by using night garments is that you must be attentive to how many hours you are averaging in the night garments per night. When I see patients for follow up in self-care management and they are struggling, I ask them a plethora of questions to figure out why their self-care regimen isn't working for them.

Compliance to wearing the night garment every night is only one of the questions that should be asked during a self-care management follow up appointment with your lymphedema therapist. The most important question is how many hours are you averaging each night in the night garment? The reason why this question is so important is because some patients only sleep 3-4 hours a night.   If a night garment is mistakenly understood as a garment to be worn only when you are sleeping, the effected limb may not be getting as many quality hours in the night garment as it should be.

This simple but extremely important question has solved issues that arise in self- care management much quicker. I make a conscious effort to educate my patients about how many hours of use are recommended for any of their compression garments when I am teaching them how to independently manage their swelling. I typically recommend that my patients shoot for 12 hours in the night garment which gives them less than 12 hours in the daytime elastic compression, given that you will be showering or cleansing the skin in between. This may vary per patient depending on the lifestyle, assistance needed, severity of lymphedema, and willingness to comply.  

Some patients must use night garments 24 hours/day. Some other patients may only use the night garments when they need a break from self-bandaging for a night.   Others may use the night garment during the day to add to the number of hours in a night garment within a 24-hour period. Regardless, it is important to ask your lymphedema therapist how long they recommend you use the night garment because success in self-care management could depend on it.

Because different patients perceive the use of the term "Night Garment" differently, I have changed my terminology with patients from "Night Garment" to "Alternative Compression Garment" or "Nonelastic Compression Garment". This doesn't cause any confusion or misunderstanding when instructing a patient when or how to use the garment.

Therapist review: Leslyn Keith, MS, OTR/L, CLT-LANA

Central Coast Lymphedema Therapy

San Louis Obispo, CA

I find the LymphaPod® pneumatic compression therapysystem an effective treatment option for bariatric and larger sized patients who need treatment of the abdomen, genitals and buttocks as well as the legs. It is particularly beneficial for those patients with less mobility, who have difficulty donning and doffing other compression garments.

I have had good success with the LymphaPod. It's been highly effective for softening fibrotic tissue and making edema easier to evacuate. The appliance fits the bariatric-sized patient better because of its design, and addresses edema in the trunk, and especially the dependent edema in the pannus. My patient is motivated to use it regularly because of how well it works. I consider it to be an essential part of my bariatric patient's home program. He would not be able to manage his lymphedema without it."

Patient review: L. Kelley, lymphedema patient

Ripon, CA

After using the LymphaPod, I feel lighter and can move around better. It really helps reduce my edema, particularly in my abdomen. I don't feel as stuck in one place and it makes it easier for me to walk. I get from a sitting to a standing position more easily. I feel less heaviness and pressure which makes it easier for me to sleep. After using the LymphaPod my body doesn't hurt as much; using it gives me hope. I look forward to using it each time, and it has changed my life. 

Contact Lympha Press USA www.lympha-press.com, toll free 888-596-7421 for information.

Lymphedema Treatment Act Update